What is a name? The accuracy of using surnames and forenames in ascribing south Asian ethnic identity in English populations.J7 Epidemiol Community Health (in press).

Background: Non specific low back pain (NSLBP) has been identified as one of the commonest rheumatic disorders in prevalence surveys in Asia-PacificObjective: Development of a core questionnaire for identification of risk factors of NSLBP at community level.Methods: Following steps were followed: 1) item generation from literature survey, existing Nordic questionnaires and patient focus group discussions, 2) development of a preliminary APLAR-COPCORD English questionnaire, 3) translation into target language, back translation and development of a synthetic target language version, 4) adaptation of the synthetic target language version through tests of comprehensibility, content validity test-retest reliability, and 5) finalization of the English questionnaire. .Results: 45 items were generated. A preliminary English questionnaire was developed.Conclusion: The developed English questionnaire will serve as an efficient tool for identification of risk factors of NSLBP in Asia-Pacific communities.TAJ 2011; 24(2): 85-90

Thirty one (78%) of 40 consecutive patients (aged 13-79, mean 44 years) with infective endocarditis had congestive heart failure at presentation. Twenty six (65%) had had rheumatic heart disease and 17 (43%) patients had prosthetic valves. Eight (20%) patients had undergone dental procedures within three months of presentation. Blood cultures were positive in only 22 (55%) of the patients. In nine (41%) of them streptococci of the viridans group were isolated and in seven (32%) patients endocarditis was due to Staphylococcus aureus. Eight patients had Q fever endocarditis. Sixteen patients required operation because of haemodynamic deterioration while they were in hospital; 11 patients had native valves and five had prosthetic valves. Seven had emergency operations and were pyrexial at that time. Four of the seven died in hospital. Of the 12 who were alive and well after surgery only two required further surgery two and three years after the initial operation. Twelve (30%) of the 40 patients died in hospital; in 10 death was mainly due to left ventricular failure or congestive heart failure. All patients died who had renal failure (four cases), myocardial infarction (two cases), complete heart block (one case), or ventricular fibrillation (two cases) before operation. Six (33%) of the 18 patients with culture negative endocarditis died. Two of the four patients seen and treated more than 12 weeks after the onset of symptoms died, as did three of the five patients with prosthetic valves who required surgery while in hospital. Three patients with neurological complications survived and only two (29%) of the seven patients with blood cultures that were positive for Staphylococcus aureus died. Of these 40 high risk patients optimal antibiotic treatment and early surgery for haemodynamic difficulty ensured that 28 (70%) were discharged from hospital alive and well.

Clinical and echocardiographic findings were compared with those found at operation in 18 consecutive patients with active endocarditis undergoing valve replacement for continuing left ventricular failure. A close correlation was shown between vegetations detected by echocardiography and those found at operation. In 10 of 11 patients with clinically suspected severe aortic regurgitation and vegetations only on the aortic valve and in two of three patients with severe mitral regurgitation echocardiography provided confirmation of the clinical diagnosis. In the three patients with clinically suspected aortic and mitral regurgitation, however, cardiac catheterisation was necessary to confirm the severity ofthe valvular regurgitation. In a further three patients cardiac catheterisation was carried out as the severity of the single valve lesion was difficult to assess or there were associated problems, that is chest pain with myocardial infarction and a sinus of Valsalva aneurysm. Four patients had either an abscess, annular infection, a sinus, or a ventricular septal defect at the time of operation, which were not detected by echocardiography. Nevertheless, because of their size it would be doubtful if these would have been identified by cardiac catheterisation. Echocardiography allowed repeated assessment of the patient so that the optimal time for operation could be determined without the risks ofleft heart catheterisation. Fourteen ofthe 18 patients (78%) survived to leave hospital. The follow-up extended to 44 months. During this time reinfection, prosthetic dehiscence, or paravalvular leaks did not occur. Thus, in the majority of patients with left sided active infective endocarditis and continuing left ventricular failure resulting from severe valvular disease the clinical findings together with echocardiography provide a satisfactory preoperative assessment.

To identify the causes of haemoptysis and to diagnose the diseases clinically and cost effective laboratory investigations in our situation. Fifty consecutive cases of haemoptysis admitted at Rajshahi Medical College Hospital, Rajshahi during 2000-2001 were prospectively studied .Pulmonary tuberculosis was the commonest found in 19 (38%) cases. Tuberculer bacilli could be isolated in 5 (26.31%) of the cases. Eight (16%) patients were mitral valvular diseases . Bronchial carcinoma was 4(8%) of the series. Three patients (6%) were lung abscess. Six patients (12%) had bronchiectasis. Five patients (10%) had pneumonia. Remaining five (10%) patients were miscellaneous aetiology. In the present series it has been found that pulmonary tuberculosis and mitral valvular disease comprise 54% of the cases. Chest X-ray and sputum examination were found to be the two most useful investigations necessary for aetiological diagnosis of haemoptysis. Within limited resources the aetiological diagnosis of haemoptysis can easily be done in the majority of cases by doing chest X-ray and sputum examination in our country.